Adult brain volume in multiple sclerosis: The impact of paediatric onset

Background: ‘No evidence of disease activity’ (NEDA), defined as absence of magnetic resonance imaging activity (T2 and/or gadolinium-enhanced T1 lesions), relapses and disability progression (‘NEDA-3’), is used as a comprehensive measure of treatment response in relapsing multiple sclerosis (RMS), but is weighted towards inflammatory activity. Accelerated brain volume loss (BVL) occurs in RMS and is an objective measure of disease worsening and progression. Objective: To assess the contribution of individual components of NEDA-3 and the impact of adding BVL to NEDA-3 (‘NEDA-4’) Methods: We analysed data pooled from two placebo-controlled phase 3 fingolimod trials in RMS and assessed NEDA-4 using different annual BVL mean rate thresholds (0.2%–1.2%). Results: At 2 years, 31.0% (217/700) of patients receiving fingolimod 0.5 mg achieved NEDA-3 versus 9.9% (71/715) on placebo (odds ratio (OR) 4.07; p < 0.0001). Adding BVL (threshold of 0.4%), the respective proportions of patients achieving NEDA-4 were 19.7% (139/706) and 5.3% (38/721; OR 4.41; p < 0.0001). NEDA-4 status favoured fingolimod across all BVL thresholds tested (OR 4.01–4.41; p < 0.0001). Conclusion: NEDA-4 has the potential to capture the impact of therapies on both inflammation and neurodegeneration, and deserves further evaluation across different compounds and in long-term studies.

Download Full-text

The Effect of Body Mass Index on Brain Volume and Cognitive Function in Relapsing–Remitting Multiple sclerosis: A CombiRx Secondary Analysis

Journal of Central Nervous System Disease ◽

10.1177/11795735211042173 ◽

2021 ◽

Vol 13 ◽

pp. 117957352110421

Author(s):

Aliza Bitton Ben-Zacharia ◽

Malvin N. Janal ◽

Abraham A. Brody ◽

Jerry Wolinsky ◽

Fred Lublin ◽

...

Keyword(s):

Multiple Sclerosis ◽

Body Mass Index ◽

Cognitive Function ◽

Body Mass ◽

Multivariate Regression ◽

Mixed Model ◽

Brain Volume ◽

Relapsing Remitting ◽

The Mean ◽

The Impact

Background Multiple sclerosis (MS) is an autoimmune disease leading to physical, emotional and cognitive disability. High body mass index (BMI) may impact cognitive function and brain volume in MS. Yet, there is paucity of evidence addressing the impact of BMI on cognitive function and brain volume in MS. Objectives The purpose of this study was to examine the effects of BMI on normal appearing brain volume and cognitive function in patients with relapsing–remitting MS. Methods A secondary data analysis of the NIH CombiRx study was conducted. Multivariate regression and mixed model analyses were executed to analyze the effect of BMI on brain volume and cognitive function. Results The mean baseline age of the 768 participants was 38.2(SD = 9.4) years. 73% were female and 88.8% were Caucasian. The mean BMI was 28.8 kg/m2(SD = 6.7). The multivariate regression and mixed model analyses failed to show a clinical effect of BMI on brain volume and cognitive function. Conclusion BMI did not show an effect on cognitive function and brain volume among MS patients. Although there is increased interest in the effects of modifiable factors on the course of MS, the effects of BMI on brain volume and cognitive function are debatable and warrant further research. ClinicalTrials.gov NCT00211887

Download Full-text

The impact of vascular risk factors on brain volume and lesion load in patients with early multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458517736149 ◽

2017 ◽

Vol 25 (1) ◽

pp. 48-54 ◽

Cited By ~ 6

Author(s):

Alexander Pichler ◽

Michael Khalil ◽

Christian Langkammer ◽

Daniela Pinter ◽

Stefan Ropele ◽

...

Keyword(s):

Risk Factors ◽

Multiple Sclerosis ◽

Brain Volume ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Lesion Load ◽

Brain Volumes ◽

Brain Volume Loss ◽

The Impact

Background: Vascular risk factors (VRF) in multiple sclerosis (MS) patients have been associated with lower brain volumes. It is currently unknown if this association already exists in early MS and how it develops over time. Methods: We identified 82 patients with clinically isolated syndrome (CIS) ( n = 61) or with early relapsing-remitting MS ( n = 21) and assessed their VRF including arterial hypertension, hyperlipidaemia, diabetes mellitus and smoking. We analysed T2-lesion load, normalized brain volume (NBV), cortical grey (cGMV) and white matter volumes (WMV), thalamic and basal ganglia volumes at baseline and follow-up magnetic resonance imaging (MRI) and assessed the percentage of brain volume change (PBVC) using SIENA. Results: Patient mean age was 32.4 (±8.7) years and 54 (65%) were women. Median follow-up period was 42 (29–54) months. In total, 26 patients (31.7%) had one or more VRF (VRF+). At baseline, VRF+ patients had a lower NBV (1530.9 cm3 vs 1591.2 cm3, p = 0.001), a lower cGMV (628.5 cm3 vs 668.6 cm3, p = 0.002) and WMV (752.2 cm3 vs 783.9 cm3, p = 0.009) than VRF-negative patients. Similar results were obtained at follow-up. PBVC was comparable between patients with and without VRF. Conclusion: VRF are associated with lower brain volume already in early MS but do not lead to increased brain volume loss during 3.5 years of follow-up.

Download Full-text

The impact of child care on child development in daycare and at home

Pediatria i Medycyna Rodzinna ◽

10.15557/pimr.2020.0053 ◽

2020 ◽

Vol 16 (3) ◽

pp. 289-294

Author(s):

Archie Arman Dwiyatna ◽

◽

Irwanto Irwanto ◽

Yunias Setiawati ◽

Indrayuni Lukitra Wardhani ◽

...

Keyword(s):

Brain Volume ◽

Total Sample ◽

Adult Brain ◽

Working Parents ◽

Continuous Evaluation ◽

Parents And Children ◽

Insufficient Amount ◽

The Impact ◽

The Brain ◽

At Home

Background: The insufficient amount of time allocated by working parents is one of the causes of reduced interaction between parents and children. Consequently, the solution of entrusting children to daycare centres remains a choice. The development of children aged 3–72 months is extremely significant because the brain volume develops to reach 95% of the adult brain volume. This makes the stimulation provided by caregivers extremely important. This study aimed to identify differences in the development of children entrusted to daycare centres compared to the home care. Methods: The study was performed in Surabaya, Indonesia. The total sample was divided into 2 groups of children aged 3–72 months, one group was cared for at home, and the other in the daycare setting. The subjects were assessed using Indonesia’s Prescreening Developmental Questionnaire (PDQ) to determine their development. The assessment was conducted twice, with the second evaluation taking place 6 months after the first analysis. Results: We analysed data from 193 children. The children cared for at home differed significantly (53.3%) from the children entrusted to daycare centres (38.8%) in the first assessment, while in the second assessment 44.4% of the former group experienced a disruption of their personal-social skills, compared 38.8% in the latter. Gross motor and speech-language skills changed significantly improved in 6 months’ evaluations. Conclusion: There were no differences between the development of children being cared for at home and those that were entrusted to daycare centres over 6 months of continuous evaluation.

Download Full-text